Zeitschrift für Gerontologie und Geriatrie
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This review presents criteria for diagnosing the "syndrome of dementia" based on the S3 guidelines of the AWMF ("Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften") in Germany. They represent the best standards of evidence-based international knowledge, in light of the National Institute for Health and Clinical Excellent (NICE), the Scottish Intercollegiate Guidelines Network (SIGN), etc. ⋯ All the current guidelines specify a two-step procedure: the first step entails performing a comprehensive diagnosis of the syndrome, while the second step involves diagnosing the precise etiology. The following article focuses on the first step: diagnosis of the syndrome.
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For the treatment of geriatric inpatients, the efficacy of a multimodal geriatric intervention based on findings of a comprehensive geriatric assessment has well been established. Therefore, the focus of elderly inpatient care switched to the identification of geriatric patients who have unintended or unscheduled contact to an accident and emergency department. In Germany, a uniform standard on how to correctly identify geriatric patients in such settings has yet to be established. ⋯ Three recommendations are made: (1) The use of prognostic indices is not recommended, as prognostic indices appear to be inappropriate to disclose the complex needs of geriatric patients. (2) Comprehensive geriatric assessment is established and effective, but too complex for use in the emergency setting. It is recommended for cases in which information from screening instruments or other sources does not allow a clear decision. (3) Among screening instruments, the Identification of Seniors At Risk (ISAR) screening tool seems to be well established and suitable for screening purposes in Germany. A German adaption is recommended as well as the implementation in settings where no other tools or geriatric expertise are available.